磁共振下输卵管造影在不孕症诊断中的价值

目的:探讨磁共振成像技术在输卵管造影中的诊断价值。方法:选取20名不孕症妇女进行盆腔常规磁共振扫描及磁共振子宫输卵管造影(MR-HSG),20名患者接受前半年均接受过常规的X线下子宫输卵管造影(HSG)检查。常规扫描后患者子宫腔内置入子宫输卵管造影导管后再给予动态Flash-3D冠状位扫描,同时向宫腔内注射1∶100钆双铵稀释液,扫描后数据数字减影重建。结果:20名患者中均成功实施检查。检查结果与检查前常规HSG结果对比,有1例患者,常规HSG下提示左侧输卵管间质部阻塞,而MR-HSG提示该侧输卵管通畅,1例患者常规HSG下提示双侧输卵管积水,双侧输卵管阻塞,在MR-HSG提示双侧输卵管积水,但通畅。另有1例患者,常规X线下输卵管阻塞但MR-HSG提示右侧输卵管通畅,其余患者检查结果同检查前常规HSG结果一致。在MR盆腔平扫过程中能很好的显示盆腔情况及子宫内膜情况,同时很好的显示出子宫畸形的状态,子宫平滑肌瘤以及输卵管积水等盆腔情况。结论:常规MRI平扫结合MR-HSG能很好的显示输卵管、卵巢、子宫及盆腔相关结构,在不孕症的诊断过程中有较高的临床实用价值。

Diagnostic Value of MR-Hysterosalpingography in Tubal Patency

Objective: To discuss the value of MR-hysterosalpingography(HSG) in diagnosing the tubal patency.Methods: A total of 20 infertile women were referred to conventional pelvic scanning by MRI and MR-HSG,and all subjects underwent conventional HSG under fluoroscopy 6 months averagely before MR-HSG.Standard axial,sagittal and coronal T2-weight and axial T1-weight sequences were acquired.A balloon catheter was placed into the uterine cavity and then flash 3D coronal MR scanning was performed,with the uterine injection of diluted Gadodiamide(1:100).Digital subtraction reconstruction was performed according to the data acquired.Results: The tubal patency in 20 women was successfully evaluated using MR-HSG,and the results were compared with those of conventional HSG.One case showed left interstitial fallopian tube occlusion under the conventional HSG,but showed patency under MR-HSG.Another case with bilateral fallopian tube occlusion and hydrosalpinx under conventional HSG showed only hydrosalpinx but no occlusion under MR-HSG.The third case with bilateral fallopian tube occlusion under X ray had only left side occlusion under MR-HSG.The results by the two methods were similar in the remaining patients.MR scanning on pelvis showed more clearly in pelvic organs,endometrial state,uterus malformation,hysteromyoma,and hydrosalpinx.Conclusion: Routine MRI scan combined with HSG can better display the fallopian tubes,ovaries,uterus and pelvic tissues,so it has a high clinical value in the diagnosis of infertility.